title: Impact of prophylactic percutaneous endoscopic gastrostomy on malnutrition and quality of life in patients with head and neck cancer: a randomized study.
abstract: BACKGROUND
  The purpose of this randomized study was to examine if a prophylactic percutaneous endoscopic gastrostomy (PEG) for enteral nutrition could prevent malnutrition, reduce hospital stay, and improve health-related quality of life (HRQOL).
  
  
  METHODS
  One hundred thirty-four patients with advanced head and neck cancer were randomized to either prophylactic PEG (study group) or clinical praxis (control group). Patients' weight, body mass index (BMI), need for hospitalization, and HRQOL were noted at 7 occasions during 2 years.
  
  
  RESULTS
  No difference in hospital stay was found. After 6 months, HRQOL was significantly better and the weight loss was significantly less in the study group. The number of malnourished patients were consistently about 10% lower in the study group during the first study year. The study group started to use enteral feeding significantly earlier and for a significantly longer time period (p < .0001).
  
  
  CONCLUSIONS
  Prophylactic PEG was associated with significantly earlier start and longer use of enteral nutrition, fewer malnourished patients over time, and improved HRQOL at 6 months posttreatment start.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, Göteborg Sweden. ewa.silander@vgregion.se
authors.forename: Ewa
authors.initials: E
authors.lastname: Silander
authors.forename: Jan
authors.initials: J
authors.lastname: Nyman
authors.forename: Mogens
authors.initials: M
authors.lastname: Bove
authors.forename: Leif
authors.initials: L
authors.lastname: Johansson
authors.forename: Sven
authors.initials: S
authors.lastname: Larsson
authors.forename: Eva
authors.initials: E
authors.lastname: Hammerlid
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D044342:Malnutrition / Q000517:prevention & control*; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome